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目的了解综合干预措施对ICU患者多重耐药菌医院感染的防控效果。方法回顾性调查某院ICU2014-01/2014-12所有多重耐药菌感染患者,为干预前组;2015-01开始实施综合干预措施,2015-01/12患者为干预后组,比较干预前后多重耐药菌(MDRO)感染情况。结果共调查ICU患者3 080例,其中干预前监测患者1 518例,发生多重耐药菌感染151例,多重耐药菌感染发病率为9.95%;其中耐碳青霉烯鲍曼不动杆菌(CRAB)感染发病率为3.82%,耐甲氧西林金黄色葡萄球菌(MRSA)感染发病率为1.84%,多重耐药/泛耐药铜绿假单包菌(MDR/PDRPA)感染发病率为1.32%;干预后监测患者1 562例,发生多重耐药菌感染98例,多重耐药菌感染发病率为6.27%;其中CRAB感染发病率为2.05%。,MRSA感染发病率为0.96%,MDR/PDRPA感染发病率为0.58%,干预前后多重耐药菌感染总发病率、CRAB、MRSA、MDR/PDRPA感染率比较,差异均具有统计学意义(χ2=13.98、8.52、4.37、4.54,P均<0.05);干预前后抗菌药物使用率及治疗性使用抗菌药物送检率比较,差异均有统计学意义(χ2=42.05、111.62,P均<0.05)。结论采取综合干预措施,可有效降低ICU多重耐药菌感染总发病率及CRAB、MRSA、MDR/PDRPA感染发病率,降低抗菌药物使用率及提高治疗性使用抗菌药物送检率。
Objective To understand the prevention and control effect of comprehensive interventions on hospital infection with multi-drug resistant bacteria in ICU patients. Methods A retrospective study was conducted on all patients with multiple drug-resistant bacterial infections in ICU from January 2014 to December 2014 in order to intervene the former group. Comprehensive interventions were implemented from January 2015 to January 2015 with the intervention group as the intervention group. Drug-resistant bacteria (MDRO) infection. Results A total of 3 080 ICU patients were surveyed. Among them, 1 518 cases were detected before intervention, 151 cases were multi-drug resistant and 9.95% were multi-drug resistant. Among them, Acinetobacter baumannii CRAB infection was 3.82%, the incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection was 1.84%, and the incidence of multi-drug / pan-drug-resistant MDR / PDRPA infection was 1.32% ; After the intervention, 1 562 patients were monitored, 98 cases of multi-drug resistant bacterial infection occurred, and the incidence of multi-drug resistant bacterial infection was 6.27%. The incidence of CRAB infection was 2.05%. , The incidence of MRSA infection was 0.96%, the incidence of MDR / PDRPA infection was 0.58%, the total incidence of multiple drug-resistant bacterial infection before and after the intervention, CRAB, MRSA, MDR / PDRPA infection rates, the difference was statistically significant (χ2 = P <0.05). Before and after the intervention, there were significant differences in the rates of antimicrobials and therapeutic rates of antimicrobials (χ2 = 42.05, 111.62, P <0.05). Conclusion The comprehensive interventions can effectively reduce the incidence of multiple drug-resistant bacterial infections and the incidence of CRAB, MRSA and MDR / PDRPA infections in ICU, reduce the use of antimicrobial agents and increase the rate of therapeutic use of antimicrobial agents.